History and Efficacy of Cognitive Behavioral Therapy

behavior modifications

Doctors use a variety of treatments to help people affected by serious substance problems and other mental health-related issues. Some of these treatments rely on the use of some sort of medication, while others call for the use of non-medication-based behavior modifications. One of the most well-regarded forms of treatment in this second category is an approach called cognitive behavioral therapy (CBT). Let’s take a look at the history of CBT, as well as its demonstrated efficacy in the real world.

CBT History

Cognitive behavioral therapy was founded in the 1960s by a University of Pennsylvania psychiatrist named Aaron Beck. Beck originally specialized in the classic form of talk therapy known as psychoanalysis. However, after carrying out a series of experiments designed to test the practical usefulness of the psychoanalytic approach in depression treatment, he concluded that the concepts underpinning this approach did not play out as expected in real-world conditions. In other words, psychoanalysis did not appear to help patients with depression get better.

Motivated by this disappointing conclusion, Dr. Beck started looking at other ways to help depressed patients. He realized that the vast majority of these patients experienced “automatic” negative thoughts over which they had no apparent control. Beck then decided to try a different treatment approach that required patients affected by depression to identify their negative thoughts and judge with a critical eye whether those thoughts had any basis in reality. Essentially, this process of grounding thought in reality allowed his patients to alter some of the deep-seated features of their negative worldviews, develop a durable, more positive outlook and make behavior modifications that support this positive outlook. Beck decided to name this new treatment approach cognitive (i.e., thought-, experience- and knowledge-related) behavioral therapy. 

CBT Efficacy

Cognitive behavioral therapy has been extensively studied as a treatment for both diagnosable substance problems and a variety of mental illnesses. In the context of substance treatment, it was first used to help prevent the occurrence of drinking relapses in people recovering from alcohol abuse/addiction. Since then, CBT-based behavioral modifications have spread as a method of addressing serious substance problems. The National Institute on Drug Abuse views the treatment as an “evidence-based approach” to helping people affected by abuse/addiction related to the consumption of alcohol, methamphetamine, cocaine, marijuana and nicotine/tobacco. This means that there is a firm scientific basis for the effectiveness of cognitive behavioral therapy in these contexts. CBT provides real-world benefits by helping people with substance problems do such things as track the intensity of their drug/alcohol cravings and avoid situations that increase the likelihood of drug/alcohol intake.

The National Alliance on Mental Illness (NAMI) reports the scientifically verified usefulness of cognitive behavioral therapy as a treatment for people affected by a range of diagnosable mental illnesses not directly related to substance use. The list of conditions that can improve as a result of CBT includes major depression and other depressive disorders, schizophrenia, various forms of bipolar disorder, various anxiety disorders and various types of eating disorders. Evidence shows that the therapy achieves part of its effectiveness by literally changing the baseline brain activity of participating individuals. NAMI notes that CBT is widely used in mental health treatment, and would almost certainly see even wider use if more therapists received the required training.



The Beck Institute: History of Cognitive Behavioral Therapy https://www.beckinstitute.org/get-informed/what-is-cognitive-therapy/

National Institute on Drug Abuse: Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine)https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral

National Alliance on Mental Illness: Psychotherapy http://www.nami.org/Learn-More/Treatment/Psychotherapy


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